Form Rev-714 - Register Of Wills Monthly Report Pennsylvania Inheritance Tax

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REV-714 (11-14)
REGISTER OF WILLS
COUNTY
NO.
MONTHLY REPORT
Date Received
Postmark Date
MONTH
YEAR
BUREAU OF IMAGING AND
DOCUMENT MANAGEMENT
PO BOX 280400
NAME
HARRISBURG, PA 17128-0400
PENNSYLVANIA INHERITANCE TAX
(1) LIEN FILING FEES (NO COMMISSION) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(2) CITATION FILING FEES (NO COMMISSION) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(3) NONRESIDENT INHERITANCE TAXES (NO COMMISSION) . . . . . . . . . . . . . . . . . . . . .
(4) TOTAL MISCELLANEOUS COLLECTIONS (ADD LINES 1 THRU 3) . . . . . . . . . . . . . . . . .
(5) RESIDENT INHERITANCE TAXES (COMMISSION ALLOWED) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(6) TOTAL COLLECTIONS (ADD LINES 4 AND 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(-)
(7) CREDIT MEMORANDA/CREDIT CORRESPONDENCE (ATTACH COPIES) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(-)
BALANCE DUE
(8) REGISTER OF WILLS (Subtract)
. . . . . . . . . . . . . . . . . . .
PRIOR REPORT FOR
+
(9) COMMONWEALTH (Add)
. . . . . . . . . . . . . . . . . . .
(MONTH)
(-)
MM/YYYY
BALANCE DUE AUDIT
(10) REGISTER OF WILLS (Subtract)
. . . . . . . . . . . . . . . . . . .
FROM
+
(11) COMMONWEALTH (Add)
. . . . . . . . . . . . . . . . . . .
TO
(12) TOTAL AMOUNT DEPOSITED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CERTIFICATION
I certify that the information contained in this report is true and correct.
(REGISTER OF WILLS SIGNATURE)
DO NOT WRITE BELOW THIS LINE
OFFICIAL SETTLEMENT
TOTAL MISCELLANEOUS COLLECTIONS (NO COMMISSION) . . . . . . . . . . . . . . . . . . . . .
RESIDENT INHERITANCE TAXES (COMMISSION ALLOWED) . . . . . . . . . . . . . . . . . . . . .
TOTAL COLLECTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CREDIT MEMORANDA/CREDIT CORRESPONDENCE . . . . . . . . . . . . . . . . . . . . . . . . . . .
BALANCE DUE OR CREDIT
FOR MONTH OF
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
AUDIT SETTLEMENT
FROM
TO
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
AMOUNT DUE COMMONWEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
TOTAL DEPOSITS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
BALANCE DUE:
(
) REGISTER OF WILLS . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(
) COMMONWEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
COMMISSION DUE THIS MONTH
COMMISSION ADJUSTMENT(S)
FOR MONTH OF
COMMISSION PAID
DEPARTMENT OF REVENUE
OFFICE OF THE AUDITOR GENERAL
SETTLED AND DELIVERED
AUDITED AND APPROVED
SUBJECT TO FINAL AUDIT
SUBJECT TO FINAL AUDIT
FOR: SECRETARY OF REVENUE
FOR: AUDITOR GENERAL
PRINT
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